Histologic features associated with lymph node metastasis in stage T1 and superficial T2 rectal adenocarcinomas in abdominoperineal resection specimens. Identifying a subset of patients for whom treatment with adjuvant therapy or completion abdominoperineal resection should be considered after local excision.

摘要: Local excision of rectal adenocarcinomas that are confined to the submucosa is an accepted method surgical excision. Adjuvant therapy and possibly completion abdominoperineal resection (APR) may be appropriate if lymph node (LN) metastases present. Identifying patients at high risk having LN would assist in disease management. We retrospectively examined 73 APR specimens with T1 or superficial T2 adenocarcinomas. The leading edge tumor was evaluated for budding, microacinar structures, isolated small clusters undifferentiated cells. features were correlated metastases. Eleven had Extensive cells, grade 3, vessel vascular space invasion associated Limiting comparison 1 2 showed association extensive microtubular architecture, cells along advancing LN-metastases. If these histologic extensively present, patient a candidate adjuvant APR. morphologic independent neoplastic glands within body tumor; they can incorporated into evaluation overall grade.